Lifestyle Changes for Disease Prevention

Factors associated with high and low mental well-being in Spanish university students

BACKGROUND

Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain.

METHODS

MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables.

RESULTS

Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB.

LIMITATIONS

The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys.

CONCLUSION

The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.

Correlation of health literacy, health management self-efficacy, and attitude in elderly patients with schizophrenia: A cross-sectional study

AIM

The study investigated the relationship between chronic diseases and health problems, emotional health status, health literacy, health self-management attitude, and health management self-efficacy in older patients with schizophrenia. It is expected to provide multiple health perspectives in the care of older patients with schizophrenia and improve their health literacy and self-management.

DESIGN

A cross-sectional study.

METHODS

Data collection from 2020/09 to 2021/10, the study of older patients with schizophrenia who were diagnosed with schizophrenia and were over 50 years, live in residential mental rehabilitation institutions in eastern Taiwan as older people. Data were collected on demographic variables, chronic diseases, health problems, health literacy, healthy management self-efficacy, and attitudes.

RESULTS

The study results show 61.49 years (SD = 6.57), the gender, health literacy, and health management self-efficacy can effectively explain the variance of health self-management state by 18.5% (F(3,116)  = 10.01, p < 0.000), in which health literacy (β = 0.28, t = 3.07, p = 0.003) and health management self-efficacy (β = 0.19, t = 2.03, p = 0.04) that in the analysis of predictors, emotional health status, and health literacy not only have significant explanatory power on health management self-efficacy and the performance of physical functions but are also important factors affecting the quality of life among the elderly; the important influencing factor of health management self-efficacy and health self-management behaviour is health literacy. Therefore, health literacy is crucial to the health attitudes of older patients with schizophrenia.

CONCLUSION

This study found that increased health literacy among older patients with schizophrenia can enhance their attitude and ability to manage their health. IMPLICATIONS FOR THE PROFESSION AND NO PATIENT OR PUBLIC CONTRIBUTION: Nursing can provide nursing measures related to individual health literacy to help patients improve their health literacy, maintain the health of chronic older patients with schizophrenia, reduce elderly schizophrenia disability, enhance patients' ability to manage their self-efficacy and health self-management attitude, and improving the health and quality of life of patients.

The Family Environment as a Source for Creating the Dietary Attitudes of Primary School Students-A Focus Group Interview: The Junior-Edu-Żywienie (JEŻ) Project

The family environment plays a crucial role in creating the health behaviours of children and youth. This study aimed to explore the attitudes of parents with children aged 7-12 who represent an influential environment for creating the eating behaviours of children. A qualitative study was conducted using focus-group interviews (FGI) involving 101 parents from various socioeconomic backgrounds. Three categories of parents were identified based on their level of involvement and awareness of nutrition: 'aware', 'determined', and 'relaxed'. Among parents of 10-12-year-old students, an additional category, 'distanced' parents, was identified. The study revealed that parents require support in terms of providing compelling arguments and practical recommendations related to meals and reducing or eliminating their children's consumption of sweets, snacks, fast food, and, in the case of older students, energy drinks. Parents reported that their children had a moderate understanding of the principles of proper nutrition. The majority of respondents viewed this knowledge as primarily theoretical and expressed a need for practical guidance and activities, which they believe should be offered by schools. To achieve positive outcomes in educational activities related to food and nutrition, it is essential to involve children, parents, guardians, teachers, and other school staff in these efforts.

The Attitudes of 7-9 Year Old Primary School Students towards Food and Nutrition: Insights from Qualitative FGI Research-The Junior-Edu-Żywienie (JEŻ) Project

Optimal nutrition is one of the most significant environmental factors affecting human health. The aim of this study was to assess the attitudes of primary school students aged 7-9 towards nutrition considering three fundamental components: knowledge, emotional disposition, and dietary behaviors. The research was conducted using the Focus Group Interview (FGI) technique among 78 children. Considering their attitudes towards food and nutrition, four profiles were identified: "engaged", "obedient", "reluctant", and "indifferent". Children who were "engaged" and "obedient" due to their parents' involvement in creating their dietary attitudes exhibited the most alignment with the principles of optimal nutrition. Regardless of profile type, it was observed that children were familiar with recommended and unrecommended food products, as well as the role of water in proper nutrition. It was demonstrated that parents wield the most substantial influence on children's nutrition. As a result, initiatives promoting the proper nutrition and a healthy lifestyle should commence with parents. Children of nutritionally conscious parents tend to eat more healthily and demonstrate a high nutritional awareness. Conversely, the children of busy parents who lack time for meal preparation more frequently replicate their parents' nutritional mistakes. These findings emphasize the importance of the family environment in shaping the dietary behaviors of children and youth.

Effects of a lifestyle intervention on the biomarkers of oxidative stress in non-communicable diseases: A systematic review

Oxidative stress plays a critical role in the pathogenesis of chronic diseases. Therefore, improvement of oxidative stress status through lifestyle intervention can play a vital role in preventing and treating chronic diseases. This systematic review aims to provide an overview of articles published in the last decade examining the association between lifestyle intervention and oxidative stress biomarkers in the context of non-communicable diseases. The electronic databases PubMed and Web of Science were searched for relevant studies, following the PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) guidelines. This systematic review focused on the four important oxidative stress biomarkers; glutathione (GSH), superoxide dismutase (SOD), catalase, and malondialdehyde. 671 articles were identified, of which nine met the inclusion criteria. A trend emerged, showing that lifestyle modifications that focus on diet and physical health can improve oxidative stress in the form of an increase in superoxide dismutase and CAT levels and a decrease in Malondialdehyde levels in participants with non-communicable diseases (NCDs), GSH levels were not affected. However, the results are difficult to compare because of the heterogeneity of the methods of the biomarkers studied. Our review indicates that oxidative stress can be influenced by lifestyle modifications and may be an effective tool for the prevention and management of non-communicable diseases. This review also elucidated the importance of analyzing multiple oxidative stress biomarkers to evaluate oxidative stress, it further highlights the need to conduct long-term lifestyle intervention studies on oxidative stress biomarkers to understand the connection between oxidative stress biomarkers, NCDs and Lifestyle intervention.

Promoting University Students' Mental Health through an Online Multicomponent Intervention during the COVID-19 Pandemic

The mental health of university students is a serious public health issue. The alarming trend of high levels of untreated psychological distress observed during the COVID-19 pandemic highlights the need for prevention programs. Digital tools are a promising means of delivering such programs. Web-based programs are acceptable and effective at improving mental health problems and general mental well-being. However, the usefulness of such digital prevention approaches to address the multiple issues raised by the COVID-19 pandemic needs to be tested. The current study assessed the effectiveness of an 8-week online intervention, integrating a variety of evidence-based strategies for improving French university students' mental health. Students were assigned to: (1) the online self-help program ETUCARE (n = 53), or (2) the control condition (n = 50). All the participants completed pre- and post-intervention questionnaires that assessed mental health problems and psychological well-being. The findings revealed that, compared to the control group, participation in the online program was associated with higher levels of psychological well-being post-test and fewer clinical symptoms of psychological distress, anxiety, and alcohol consumption. These preliminary findings suggest that the ETUCARE program is a promising multicomponent intervention to buffer the mental health consequences of the COVID-19 pandemic in French university students.

The Regulatory Effects of Citrus Peel Powder on Liver Metabolites and Gut Flora in Mice with Non-Alcoholic Fatty Liver Disease (NAFLD)

Gannan navel orange and Jinggang pomelo, belonging to the genus Citrus, are good sources of phenolic compounds, which are mainly concentrated in the peel. These phenolic compounds are considered promising in the prevention and treatment of non-alcoholic fatty liver disease (NAFLD). In order to maximize nutrients retention and bioactivity in the peel, pomelo peel and orange peel were processed using freeze-drying technology and mixed in the ratio (pomelo peel powder 50% and orange peel powder 50%) to make citrus peel powder (CPP). The purpose of this study was to explore new strategies and mechanisms associated with the consumption of CPP to alleviate nonalcoholic fatty liver injury, lipid metabolism disorders, and gut microbiota dysbiosis in obese mice induced by high-fat diet (HFD). The results showed that after 12 weeks of CPP administration, CPP supplementation had a strong inhibitory effect on HFD-induced weight gain, hepatic fat accumulation, dyslipidemia, and the release of pro-inflammatory cytokines. In particular, CPP modulates the composition of the intestinal flora, such as increasing the relative abundance of phylum Firmicutes, genus Faecalibaculum, genus Lactobacillus, genus Dubosiella, and genus Lachnospiraceae_NK4A136_ group and decreasing the relative abundance of phylum Bacteroidota, genus Helicobacter, and genus Bacteroides. These results suggest that CPP has a preventive effect on NAFLD, which can be related to the regulation of intestinal flora.

Stopping Anti-TNF in Crohn’s Disease Remitters: Pros and Cons: The Pros

<b><i>Background:</i></b> There is no cure for Crohn’s disease (CD). Available treatments and treatment strategies, particularly anti-TNF, allow healing intestinal lesions and maintaining steroid-free remission in a subset of patients. Having in mind the remitting/relapsing nature of the disease, patients and health care providers often ask themselves whether the treatment could be withdrawn. Several studies have demonstrated a risk of relapse of CD after anti-TNF withdrawal, which varies from 20 to 50% at 1 year and from 50 to 80% beyond 5 years. These numbers clearly highlight that stopping therapy should not be a systematically proposed strategy in those remitting patients. <b><i>Summary:</i></b> Nobody would argue for anti-TNF withdrawal in patients with a high risk of short-term relapse. Nevertheless, they also indicate that a minority of patients may not relapse over midterm and that those who have relapsed may have benefited from a drug-free period before being again treated for a new cycle of treatment. The most relevant question is thus whether in those patients with a low to medium risk of disease relapse, treatment withdrawal could be contemplated. In this specific setting, there may be pros and cons for anti-TNF withdrawal. Among the pros are the potential side effects and toxicity of anti-TNF, the risk of loss of response over time, the patient preference allowing the patient to regain control of one’s health and investing in it, also improving adherence, the absence of a negative impact on disease evolution of a transient anti-TNF withdrawal, and finally the cost. <b><i>Key Messages:</i></b> Although anti-TNF withdrawal in patients with sustained clinical remission is associated with a high risk of relapse, this risk seems to be much lower in a subgroup of patients, particularly in endoscopic and biologic remission. Stopping anti-TNF in this subgroup of patients may be associated with a favorable benefit/risk ratio.

Evaluation of Bioactive Metabolites and Antioxidant-Rich Extracts of Amaranths with Possible Role in Pancreatic Lipase Interaction: In Silico and In Vitro Studies

Fat/carbohydrate-rich diet consumption or elevated secretion of pancreatic lipase (PL) in pancreatic injury results in increased fat digestion and storage. Several metabolites in plant-based diets can help achieve the requirements of nutrition and fitness together. Presently, nutritional metabolites from Amaranthus tricolor, A. viridis, and Achyranthes aspera were assessed and predicted for daily intake. The volatile-metabolite profiling of their extracts using GC-MS revealed various antioxidant and bioactive components. The implication of these specialized components and antioxidant-rich extracts (EC₅₀ free radical scavenging: 34.1 ± 1.5 to 166.3 ± 14.2 µg/mL; FRAP values: 12.1 ± 1.0 to 34.0 ± 2.0 µg Trolox Equivalent/mg) in lipolysis regulation by means of interaction with PL was checked by in silico docking (Betahistine and vitamins: ΔGbind -2.3 to -4.4 kcal/mol) and in vitro fluorescence quenching. Out of the various compounds and extracts tested, Betahistine, ATRA and AVLA showed better quenching the PL fluorescence. The identification of potential extracts as source of functional components contributing to nutrition and fat regulation can be improved through such study.

Addressing the COVID-19 Mental Health Crisis: A Perspective on Using Interdisciplinary Universal Interventions

Mental health is reaching a crisis point due to the ramifications of COVID-19. In an attempt to curb the spread of the virus and circumvent health systems from being overwhelmed, governments have imposed regulations such as lockdown restrictions and home confinement. These restrictions, while effective for infection control, have contributed to poorer lifestyle behaviors. Currently, Positive Psychology and Lifestyle Medicine are two distinct but complimentary disciplines that offer an array of evidence-based approaches for promoting mental health and well-being across a universal population. However, these strategies for improving mental health are typically used in isolation. This perspective calls for a new paradigm shift to create and rollout well-designed interdisciplinary universal multicomponent mental health interventions that integrates the benefits of both disciplines, and uses innovative digital mental health solutions to achieve scalability and accessibility within the limitations and beyond the COVID-19 lockdown and restrictions.

Recommended Musculoskeletal and Sports Medicine Curriculum for Internal Medicine Residency Training

ABSTRACT

Patients present to primary care physicians with musculoskeletal complaints more often than they do for upper respiratory infections, hypertension, or diabetes. Despite this, instruction in musculoskeletal medicine for internal medicine residents represents less than 1% of their total didactic and clinical education time. We recognize the immense breadth of knowledge and skill required to train residents in the practice of internal medicine. This curriculum guideline defines a recommended training strategy, and supplies relevant resources, to improve musculoskeletal education among internal medicine residents to optimize patient care. This curriculum guideline was created by internists who are sports medicine specialists. Sports medicine physicians promote overall health and well-being while providing expertise in acute and chronic musculoskeletal conditions, as well as how disease affects exercise and using exercise as medicine for people with chronic disease.

The Feasibility of Using Computrition Software for Nutrition Research-A Pilot Study

We evaluated the feasibility of using Computrition to design and implement a low vs. typical sodium meal plan intervention for older adults. Dietitians used Computrition to design a 7-day meal plan with three caloric levels (≤1750, 2000, ≥2250 kcals/day) and two sodium densities (low = 0.9 mg/kcal; n = 11 or typical = 2 mg/kcal; n = 9). Feasibility was determined by post-hoc definitions of effectiveness, sodium compliance, palatability of diet, sustainability, and safety. Given the low number of participants in one of the three calorie groups, the higher calorie groups were combined. Thus, comparisons are between low vs. typical meal plans at two calorie levels (≤1750 or ≥2000 kcals/day). Overall, regardless of the calorie group, the meal plans created with Computrition were effective in reaching the targeted sodium density and were safe for participants. Furthermore, individuals appeared to be equally compliant and reported similar palatability across meal plans. However, one of the three criteria for the sustainability definition was not met. In conclusion, we successfully used Computrition to design low and typical sodium meal plans that were effective, compliable, and safe. Future studies of older adults in similar settings should focus on improving the palatability of the meal plans and scaling this protocol to larger studies in older adults.

Doctors' smoking control knowledge, attitudes and practices: a cross-sectional study conducted in Shandong Province, China

Background

Doctors play an important role in smoking control. This study aimed to assess doctors’ smoking control knowledge, attitudes and practices to help doctors raise awareness of smoking control assistance.

Methods

This cross-sectional study recruited 1046 doctors from Shandong Province, China, by using multistage sampling. Participants’ information was collected by questionnaire. Pearson’s χ² test and Fisher’s exact probability method were used to compare the distributions of categorical variables between/among groups.

Results

Among the participants, 14.7% were current smokers. Approximately 50.3% of participants had heard of smoking cessation drugs and 59.2% of participants thought that low-tar and low-nicotine cigarettes were as harmful to health as common cigarettes. Approximately 98.2 and 60.9% of participants agreed that smoking was related to lung cancer and male sexual dysfunction, respectively. Although 72.0% of participants believed that doctors should actively provide smoking cessation assistance, only 58.1% of participants considered that doctors should be responsible for providing smoking cessation assistance. Similarly, 85.2% of participants often asked about the smoking history of patients or their family members, while only 4.9% of participants had prescribed smoking cessation drugs for patients. Pediatricians had a higher proportion of “Agree” responses to the assessment items than doctors in other departments.

Conclusions

The results showed that doctors in Shandong Province did not have sufficient knowledge of smoking control. Slightly more than half of doctors thought that providing smoking cessation assistance was their responsibility. Only a few participants had prescribed smoking cessation drugs.

Nutraceutical Properties of Polyphenols against Liver Diseases

Current food tendencies, suboptimal dietary habits and a sedentary lifestyle are spreading metabolic disorders worldwide. Consequently, the prevalence of liver pathologies is increasing, as it is the main metabolic organ in the body. Chronic liver diseases, with non-alcoholic fatty liver disease (NAFLD) as the main cause, have an alarming prevalence of around 25% worldwide. Otherwise, the consumption of certain drugs leads to an acute liver failure (ALF), with drug-induced liver injury (DILI) as its main cause, or alcoholic liver disease (ALD). Although programs carried out by authorities are focused on improving dietary habits and lifestyle, the long-term compliance of the patient makes them difficult to follow. Thus, the supplementation with certain substances may represent a more easy-to-follow approach for patients. In this context, the consumption of polyphenol-rich food represents an attractive alternative as these compounds have been characterized to be effective in ameliorating liver pathologies. Despite of their structural diversity, certain similar characteristics allow to classify polyphenols in 5 groups: stilbenes, flavonoids, phenolic acids, lignans and curcuminoids. Herein, we have identified the most relevant compounds in each group and characterized their main sources. By this, authorities should encourage the consumption of polyphenol-rich products, as most of them are available in quotidian life, which might reduce the socioeconomical burden of liver diseases.

Association between dating violence and personality type in Mexican university students

Violence against women is a global health problem. Some pathological personality traits have been associated with violence. However, the relation between personality type and dating violence, especially in Mexican students, is not fully known. Therefore, the aim of this study is to evaluate the relation between personality type and dating violence in female university students of the State of Mexico, Mexico. Cross-sectional study conducted from February to September 2019 at a private university in the State of Mexico, Mexico. Female students of the bachelor’s degrees in the field of health sciences were included. Socio-demographic data, dating violence, and personality type were evaluated through questionnaires. Adjusted logistic regression models were applied, using STATA v.13. Students with an extroverted personality were 2.45 more likely to suffer dating violence (95% CI 1.29 to 4.63), adjusted for covariates. Those who reported childhood abuse (OR = 2.33, 95% CI 1.08 to 5.01) and whom their partners had a history of drug use (OR = 2.78, 95% CI 1.17 to 6.60) or who currently use drugs (OR = 4.85, 95% CI 0.92 to 25.7), were more likely to suffer dating violence, adjusted for covariates. Students with extroverted personality were more likely to experience dating violence, compared to those with introverted personality. The results show the need to produce further research to identify specific traits within extroverted female population which makes them vulnerable to dating violence.

The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials

PURPOSE

To determine, evaluate, and synthesize the best available evidence about the evidence-based pragmatic effects of acceptance and commitment therapy (ACT) on lifestyle and behavioral changes (LBCs).

DESIGN AND METHODS

The PICOS formulations were used to improve the search strategy of this systematic review with the aim to find the right evidence and ask the right questions. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's standardized critical assessment and data extraction tools.

FINDINGS

This study involved 30 randomized controlled trials (RCTs) which met the research criteria. Although the included RCTs have several limitations in themselves, the results of this study suggested that the ACT will help maintain long-term LBCs (eg, weight management, effective coping with substance-related and addictive problems, eating and physical activity).

PRACTICE IMPLICATIONS

Given that ACT is a trandiagnostic approach that promotes health-related LBCs in many diseases and populations, it seems reasonable for clinicians to use and test ACT to achieve pragmatic results.